Thrombolysis-Guided Primary Percutaneous Coronary Intervention.

A 77-year-old STEMI patient became hemodynamically unstable during attempted PCI, and operators were unable to visualize the right coronary artery ostium despite multiple attempts. Systemic thrombolysis resolved these issues and allowed PCI to proceed. This case highlights that fibrinolysis might still play a key role for some challenging cases in the era of modern PCI.